Combined respirator and inhaler.



-H. BR-AT. COMBINED BESPIRATOR AND INHALER. APPLIOATIOH FILED MAY 1 2, 1908.

912,532, Patented Feb. 16,1909;

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H. BEAT. GOMBINED-RESPIRATOR AND INHALER. APPLICATION FILED MAY 12, 1908.

912,532, 1 v Patented Feb. 16,1909.

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Patented Feb. 16, 1909.

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H BEAT. COMBINED BESPIRATOR AND INHALBB.

APPLICATION FILED MAYIZ, 1908.

' Patehted Feb. 16, 1909.

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THE NORRIS PETERS cm, vvnsumanm, n. c.

H. BRAT. COMBINED RESPIRATOR AND INHALER.

APPLICATION FILED MAY 12, 1908.

Patented Fb.16,1909.

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Patented Feb. 16, 1909.

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H. BRAT.

COMBINED RESPIRATOR AND INHALER.

APPLICATION FILED MAY 12, 1908.

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Patented Feb. 16, 1909.

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APPLICATION FILED MAY 12, 1908.

Patented Feb. 16, 1909.

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APPLIGLTION FILED MAY 12, 1908.

Patented Feb. 16, 1909.

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HEINRICH BRA'I, OF -GHARLOTIENBURG, GERMANY.

COMBINED RESPIRATGE AND INHALER.

Specification of Letters Patent.

Patented Feb. 16, 1909.

Application filed. May 12, 1908. Serial No. B2398.

To all whom it may concern:

Be it known that I, Hmnnron BEAT, a doctor of medicine and a subject of the King of Prussia, and a resident of 1S Wielandstrasse, in the city of Charlottenburg, Kingdom of Prussia, and German Empire, have invented a certain new and useful lombined Respirator and Inhaler, of which the following is a specification.

In the case that, on account of the absorption of poisonous gases, the patient has nearly ceased to respire in a natural manner, the evacuation of said gases from the lung (expiration) as well as the supply of oxygen (inspiration) must be produced in an artificial way. It may he tried, to exercise these functions in a known manner by moving the arms of the patient etc. But this attempt will not have the wished for success in most cases, the success depending on several conditions. Firstly the movements must be practiced by a person having experience in this respect, and secondly it is impossible to produce artificial respiration by moving the limbs of the patient, if the latter one has suffered exterior lesions, for example broken arms etc. Therefore apparatus have been constructed which enable respiration to be induced artificially by turning a three way cock into the 1 osition in which it makes communication all taining a suitable gas under pressure, such as oxygen, and the respiratory organs, and between a source of reduced pressure and the said organs. Such apparatus, however, can only he used with advantage when the patient is in such a condition that respiration has ceased, or is so superficial that it can be influenced by the mechanism of the artificial respiration. The more, however, consciousness has returned, the more automatic does the natural respiration become, and the more difiicult is artificial respiration to be induced. Notwithstanding, the duct supplying oxygen may still be necessary, as without this the dangerous condition may remain. The mentioned apparatus, therefore, is wanting in the appropriate and absolutely desirable adaptability to the different requirements, which are to be fulfilled during an attempt at restoring life. Besides, the known apparatus cannot be used, if an operation together with narcosis is to be executed. In

this case it is not sufiicient that the apparatus allows to make oxygen-inhalatlon and to ernately between a bottle con- I spring.

produce artificial respiration in supplying oxygen, but an apparatus appropriate for these purposes must at all events permit the patient to he narcotized, if it should be neces sary. Under certain circumstances, it may so even be required to produce artificial respiration in supplying oxygen together with the narcotic.

To unite these different functions in one apparatus acting most surely and to be attended most simply and easily, is the purpose of the present invention.

In the accompanying drawings: Figures 112 show an apparatus by which especially attempts at restoring life are to be executed, while Figs. 13-23 show an apparatus especially appropriate for operating. It is to be used not only for the mentioned attempts but particularly for narcotizing. Fig. 1 is a view of the first described form of apparatus; Figs. 2 8 show the positions of the cock for different functions, Fig. 9 is a plan of a show board, and Figs. 10-12 show the manner and disposition of the ways of the cock. In a similar manner is represented in: Fig. 13 a so view of the second described form of apparatus; Figs. 1419 the characteristic positions for the diiferent functions, Fig. 20 the show-board and Figs. 21-..3 the disposition of the cock-ways.

In Fig. 1 the multi-ported cock communicates by ducts 19, 20, with a bottle or flask 21 containing oxygen under a suitable pressure, which is to be regulated by means of the reducing valve 27. In this manner it is possible to allow a comparatively feeble current of oxygen, but sufficient for resuscitation, to issue from the gas bottle 21. By the added piece 22, the cock is in communication with a bag 23. At 24 the cock communicates with the atmosphere by an ejector, while duct 25 leads to the mask 26 and to the respiratory organs of the patient. The mask 26, which may fit air tight against the face, is provided with a valve 28 which opens 10c outwards and allows the products of expiration to escape.

The multi-ported cock 29 consists in a cock proper and a show-board. The cock proper (Fig. 2) is composed of the casing 18, the exterior plug 30 and the interior plug 31. The casing is closed below by a cover which presses the plugs against each other and against the casing by means of a spiral- The space 39 between plugs and cover communicates by the port 38. with the plug 31. The show-board 35 has three designations: Inspiration- Air Expi ration. Pointer 35 is provided with a small show-board 37, which has the designations Artificial"Natural? Pointer 36 is to be turned independently with regard to pointer 35, but, being not held fast or turned, pointer 36 turns together with pointer 35, not changing naturally its position as to the small show-board 34.

In the following the different functions practiced by the apparatus, will be described with reference to the accompanying drawings.

1. Artificial respiration under introduction of oxygen (Figs. 2-4). In this case, pointer 35 shows to Inspiration and pointer 36 stands in the position: Artificial. The resulting position of the diiierent parts of the cook 29 is represented by Fig. 2. From duct 19 the oxygen flows through the port 38 into the space below the plugs, and from here through the bores 14, 7 and 1 and duct 25 to the mask 26. The valve 28 is closed so that the oxygen is pressed into the lung of the patient. If expiration is to be induced, pointer 35 is turned to Ex iration and pointer 36 shows to Artificia The ejector 24 communicating with the atmosphere leads to two ports 3 and 40f the casing. As

vshown in Figs. 3 and 4, the bore 3 communicates by the ways 9 and 2 with duct 25, the opening 4 is, however, in direct communication with the oxygen-duct by means of the bores 10 and 13 and the radial way 16 (Fig. 4). Therefore, the oxygen flowing through way 13, 10, 16 and 4 into duct 24, will produce here a vacuum and suck in this manner by duct 39, 2 and 25 the inhaled or poisonous gases out of the lung of the patient. In turning pointer 35 regularly from Inspiration to Expiration and vice versa in intervals corresponding to the phases of natural respiration, the functions of the respira tion will be produced in the simplest manner, namely the supply of fresh oxygen into the lung and the evacuation of the inhaled or poisonous gases from the lung.

' 2. Inspiration of air and production and reinforcement of expiration (F i g. 5) -.-Furthermore, the apparatus allows the patient to be directly connected with the atmosphere. For this purpose, pointer 35 is turned to the word Air, and pointer 36 to the designation Artificial, while the valve 28 of the mask 26 is opened. In thisposition, mask 26 communicates by means of diet 25, 2, 9, 3 and of the ejector 24 vith. the atmosphere. In order to induce the expiration, pointer 35 is again turned to the designation lxpiratlon, by which means the position before described in Figs. 3 and 4, is produced, that is, evacuation of the lungthrough vacuum. Also in this case, the apparatus is used by turning pointer 35 from Inspiration to Expiration and vice versa, as described above. I

3. Inhalation of oxygen without artificial evacuation (Figs. 6 and 7).lf the patient is supposed to be able to respire without artificial evacuation of the lung, the valve 28 of the mask 26 is opened, pointer 36 is turned to Natural, and pointer 35 to Inspiration, by which means the position represented by Figs. 6 and 7, is produced. As results from Fig. 10, theadded piece 22 has two ports 5 and 6, of which duct 5 leads from the cock to the bag, and duct 6 from the bag to the cock.

As shown in Fig. 6, the oxygen flows through the bores 17, 11, 5 and through nozzle 22 into the bag,'at the same time, however, port 6 leading from the bag 23 to the cock 29, communicates by the way 12-,- 15, 8, 2 and 25 with the mask 26 (Fig. 7). Inthis manner, the oxygen'may be taken from the bag 23 by the patient himself. c. bother the patient respires or not, is to be seen by the movements of the bag.

4. Direct communication of the patient with V the atmosphere without artificial evacuation (Fig. 8).-1f the patient is to be connected with the atmosphere, the mask remaining fitted air-tight against his face, pointer 35 is turned to the designation Air and pointer 36 to Natural, the valve 28 of the mask being opened. By this means, the patient communicates by duct 25, bore 2, way 9, port 3 and ejector 24 with the atmosphere.

As mentioned above, the second modification,'shown in Figs. 13-23, represents a further development of the described one, in a manner, that the apparatus can also be used for narcotizing by mixing in the current of oxygen, destined for inspiration, medicaments appropriate for gasification and inspiration, as particularly narcotics. Fig. 13 shows a schematic representation of this modification, 40 being a gas bottle containing compressed oxygen, being provided with a reducing valve 41, allowing the pressure and the supply of oxygen to be regulated. Duct 42 leads to a multi-ported cock 43, and duct 44 represents a vacuum-duct connected with a continuously acting vacuum-pump 45. This pump may be a water injector pump, but it may also be constructed in such a manner that a current of carbonic acid issuing from a gas bottle containing carbonic acid, flows through the nozzle of an ejector, carrying away surrounding air. A further way of the multi-ported cock leads through duct 46 to the mask 47 Duct 48 leads to an apparatus for gasification 49, communicating by duct 50 with a bag 51 connected by duct 52 with the cook. The apparatus for gasification has in its upper end one or more bottles 55 containing medicamental fluids and being closed at their under open parts by cocks 54. with aid of the glass 58 it is possible to observe the number of drops depending on the position of the cocks. At 56 there is another bag connected with the cock by the ducts 57 and 58.

The cook 43 consists of the multi-ported cock proper (Fig. 14) and a show-board connected with the cock. The multi-ported cock is composed of two conical plugs 59 and 60. The plugs are ground one in another and in the casing. The exterior plug 59 is fast connected with poi1-ter 61, so that every turn of pointer 61 produces an exactly correspondixg turning of the exterior plug. In a similar way the interior plug is joined with pointer 62 of the show-board so that every turn of pointer 62 will produce a correspondin turning of the interior plug 60. The show-board is provided with three designations Inspiration-hill alation Air Expiration. Pointer 61 has a small show-board 63 provided with the words: Inspiration and narcosisNarcosis-inhalation Inspiration Oxygeninhalation. The pointers are fastened in such a manner as to be surely held fast in the different positions. If pointer 61, that is the exterior plug 59, is turned, the showboard 63 is naturally turned too and generally also pointer 62, that is the interior plug 60. But pointer 62 and the interior plug may be also moved independently as to pointer 61 and the exterior plug 59.

The casi'..g is to be closed in different manners, for example, as represented in Fig. 14, by a cover 64. Ihe interior plug is tightly pressed against the exterior plug 59 by a plate of metal 65, fastened to the exterior plug 59 by set-screws. An external screw 66, fastened to cover 64, presses the plugs one st another and agai: st the casing with aid of a conical spiral-spring. T 1e oxygen e1 .ters through duct 42 into the space below the plate of metal 65. The latter one is provided with openings allowing the oxygen to pass into the space above the plate 65 so that, the oxygen duct being opened, the said space is always filled with this gas. The plugs are provided with different annul lar and radial ways and bores, the disposition of which is shown by Figs. 22 and 23, 5 Fig. 22 representin the exterior plug and Fig. 23 the interior one. In turning the bores and ways of the plugs in different ports of the casing, different positions, conduits and communications are produced by which the functions of the apparatus are operated, namely:

1. Narcosis-inhalation.1f the patient is to be narcotized, pointer 61 is turned to Inhalation, while pointer 62 is brought into the position Narcosis inhalation. By this means, the oxygen passing through duct 42 to the cock and through the openings of the plate 65 to the space between this one and the interior plug, flows from here through the bores 68, 69, t0 duct 48 leading to the apparatus for gasification 49 (Fig. 13). Here the current of oxygen carries away the narcotic, enters into the bag 51, flows through duct 52 and the bores 71, 72 into the way 73 of the interior plug 60, from which it flows through the bores 74, 75, the added piece 76 and duct 46 to the mask 47.

2. Oxygen-inhalation (Fig. 15).1f narcotizing is to be interrupted and pure oxygen is to be introduced, pointer 61 stands in the position of inhalation, while pointer 62 shows to Oxygen inhalation. In this case, the oxygen issuing from the space below the plugs filled always with this gas, passes through the openings 77, 78, 79 and duct 57 into the bag 56 from which it flows through duct 58, the way 80, 81, 82, 83, 84 and the pipe 85 to the added piece 76, that is, to the mask 47 3. Inspiration and expiration (artificial respiration) under supply of pure oxygen (Figs. 16 and 17).lf, during the narcosis, it becomes necessary to produce artificial respiration, that is, to introduce oxygen into the lung (inspiration) and to suck out the used or poisonous gases by vacuum (expiration), pointer 61 is to be turned to Inspirationinhalation and pointer 62 to Inspiration. Fig. 16 represents the resulting position of the cook, the current of oxygen flowing to the added piece 76 through the way 7 7, 74 and as well as through the bores 91, 89 and 90. It is naturally possible to connect directly the mask of the patient with the atmosphere, by turning the pointer 61 to the word. Air. In this case, the cock is brought into a similar position as described above when describing the other modification (cf. 2 Fig. 5). In order to induce expiration, the pointer 61 is turned to Expiration and pointer 62 remains standing on Inspiration (Fig. 17). The conduit 76, 75, 92 and 93 allows to connect the mask 47 with the vacuum duct 44,

- so that the lung of the patient is sucked out by an injector pump or otherwise. By turning the pointer 61 alternately to the position for Inspiration-inhalation and Expiratlon in due periods, artificial respiration 18 produced.

.4. Inspiration and expiration (artificial respiration) under supply of a narcotic (Figs;

65 manners against each other and against the l 18 and 1.9).In order to introduce the narmask 47.

cotic at the same time when producing artificial respiration, as may be necessary in many cases, ointer 61 must be turned to Inspiration-inhalation and pointer 62 to theposition of Inspiration and narcosis. As results from Fig. 18, the current of oxygen entering through the bores 91, 69 and 70 into duct 48, flows, as described before, through the apparatus for gasification to the bag 51, from which it passes through the way 52, 71, 72, 86, 74, 75 and 76 t0 the mask 47. At the same time, another current of pure oxygen passes through the bores 68, 89 and 90 to the In order to produce expiration,

ointer 61 is turned from Inspiration-inhaation to Expiration, the position of the interior plug staying unchanged in respect to the exterior one. As shown in Fig. 19, the mask 47 communicates by the added piece 76 and the ways 75, 92 and 93 with the vacuum duct, so that the lung is evacuated. In turning again pointer 61 from the position Inspiration-inhalation to Expiration and vice versa in the periods of the natural respiration, artificial respiration is induced.

As mentioned above, the lung can be pumped out by means of a water injector pump 45 producing a vacuum in duct 44.

ut the multi-ported cock having appropriate bores, vacuum may be produced in a most simple manner by using the oxygen compressed in the gas bottle. Appropriate bores are drawn on the left side of Fig. 16 with aid of dotted lines. In this case, the interior plug is provided with two interior and radial bores 95 and 98 (cf. Fig. 23). The oxygen issuing from the radial bores 95 and 98 passes through the ports 96 and 97 into duct 99, from which it flows into the vacuum duct 44 where it produces the necessary vacuum by carrying away the surrounding medium.

V1 hat I claim and desire to secure by Letters Patent of the United States is:

1. In a combined respirator and inhaler, a multi-ported cock, provided with two plugs ground one in another and in the casing of the cook, the exterior plug being fast connected with a pointer turnable on a showboard, and the interior plug communicating with another pointer movable on another show-board rigidly connected with the first named pointer, the two show-boards having designations corresponding to the functions to be practiced by the apparatus; substantially as and for the purpose set forth.

2. In a combined respirator and inhaler, an oxygen flask, an oxygen service pipe connected thereto, and a reducing valve controlling said pipe, combined with 'a facemask, and a multi-ported cock having'a pair of concentric apertured plugs that control communication between the service pipe and the face mask, substantially as specified.

3. In a combined respirator and inhaler, an oxygen flask, an oxygen service pipe connected thereto, and a reducing valve controlling said ipe, combined with a facemask, and a mu ti-ported cock having a pair of concentric apertured plugs, one of said plugs being provided with two ports that are adapted to establish communication between the service pipe and the face mask, substantially as specified.

4. In a combined respirator and inhaler,

an oxygen flask, an oxygen service pipe connected thereto, and a reducing valve controlling said pipe, combined with a bag, a face mask, and a multi-ported cock having a pair of concentric plugs that are adapted to establish communication between the service pipe and the bag, and between the bag and the face mask, substantially as specified.

5. In a combined respirator and inhaler, an oxygen flask, an oxygen service pipe connected thereto, and a reducing valve controlling said pipe, combined with means for gasifying a narcotic, a multi-ported cock having a pair of concentric plugs adapted to establish communication between the oxygen service pipe and said gasifying means, a gas bag, a face mask, and means controlled by said plugs for establishing communication between said bag and face mask, substantially as specified.

6. In a combined respirator and inhaler, an oxygen flask, an oxygen service pipe connected thereto, and a reducing valve controlling said pipe, combined with means for gasifying a narcotic, a multi-ported cock having a pair of concentric plugs adapted to establish communication between the oxygen service pipe and said gasifymg means, a gas bag, a face mask, means controlled by said plugs for establishing communication between said bag and face mask, and means also controlled by said plugs for establishing direct communication between the oxygen service piple and said mask, substantially as speci- 7. In a combined respirator and inhaler, an oxygen flask, an oxygen service pipe connected thereto, and a reducing valve controlling said pi e, combined with a face mask having a va ve, a multi-ported cock having a pair of concentric plugs, an ejector,

and means controlled by said lugs for connecting said service pi e and ace mask to the ejector, substantial y as specified.

8. In a combined respirator and inhaler,

for establishing communication between the l drawing the gaseous contents from said service pipe and one of said ducts, and bemask, substantially as specified. 10 tween the face mask and the other duct, Signed by me at Berlin, Germany this substantially as specified. 28th day of April 1908.

9. In a combined respirator and inhaler, HEINRICH BRAT. a face mask, combined with a multi-ported Witnesses: cock having a pair of concentric plugs, and WOLDEMAR HAUPT, means controlled by said plugs for with- E HENRY HASPER. 

